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Granulocytic sarcoma and subsequent acute leukemia recurrence with different biologic characteristics 5 years after allogeneic bone marrow transplantation for acute myeloid leukemia

Bone Marrow Transplantation volume 37, pages 897–898 (2006)Cite this article

A 25-year-old male with good cytogenetic risk and aberrant phenotype acute myeloid leukemia (AML) received an allogeneic transplantation from an HLA-matched sibling after an ablative conditioning regimen, achieving complete remission (CR) and full donor chimerism. He remained in CR for 2 years until a localized mammarian relapse occurred. This was treated by surgical excision. A PCR on bone marrow (BM) showed full donor chimerism. Two years later, he had a second localized relapse (inguinal adenopathy) again in the presence of full donor chimerism, and this was treated by excision alone. One year later, the patient suffered a new relapse as granulocytic sarcoma, with different characteristics compared to the initial phenotype. This was treated by radiotherapy and two fludarabine-based polychemotherapy schemes, and he received a second allograft from the same donor. Disease was refractory to treatment and the patient died of systemic aspergillosis.

In February 1998, a 25-year-old male presented with pancytopenia; BM aspirate and peripheral blood (PB) smears showed infiltration of 91% mieloperoxidase (MPO)- and alpha naphtyl esterase (α-NE)-negative blastic cells. Karyotype was 46XY, t(8,21) and molecular assays showed AML1-ETO expression. Immunophenotype was CD7+, HLA-DR+, CD34+, CD33+ and CD13+. Diagnosis of AML, FAB classification M0, with a good cytogenetic risk but aberrant phenotype was made. Chest and back X-ray, abdomen and soft tissue sonogram were negative.

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Acknowledgements

We thank Alison Frank for revising our manuscript.

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Authors and Affiliations

  1. Department of Oncology, Hematology and Bone Marrow Transplantation Unit, Transplantation and New Technology in Medicine, University of Pisa, Pisa, Italy

    M Pelosini, E Benedetti, S Galimberti, F Caracciolo, M Petrini, R Fazzi, F Andreazzoli & F Papineschi

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  1. M Pelosini
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  2. E Benedetti
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  3. S Galimberti
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  4. F Caracciolo
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  7. F Andreazzoli
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  8. F Papineschi
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Pelosini, M., Benedetti, E., Galimberti, S. et al. Granulocytic sarcoma and subsequent acute leukemia recurrence with different biologic characteristics 5 years after allogeneic bone marrow transplantation for acute myeloid leukemia. Bone Marrow Transplant 37, 897–898 (2006). https://doi.org/10.1038/sj.bmt.1705344

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